Provider Demographics
NPI:1154526812
Name:WRAMC
Entity type:Organization
Organization Name:WRAMC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:UBO MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-231-2866
Mailing Address - Street 1:9300 DEWITT LOOP
Mailing Address - Street 2:FBCH OTPT TPCP
Mailing Address - City:FT BELVOIR
Mailing Address - State:VA
Mailing Address - Zip Code:22060-5285
Mailing Address - Country:US
Mailing Address - Phone:571-231-2856
Mailing Address - Fax:
Practice Address - Street 1:103 3RD AVE SW
Practice Address - Street 2:
Practice Address - City:FORT MCNAIR
Practice Address - State:DC
Practice Address - Zip Code:20024-5120
Practice Address - Country:US
Practice Address - Phone:571-231-2856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WRAMC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-20
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1100XAmbulatory Health Care FacilitiesClinic/CenterMilitary/U.S. Coast Guard Outpatient